tbuckley/cabot-search huggingface dataset:
AB1551 IMAGING OF THE PERIPHERAL NERVOUS SYSTEM IN NOCIPLASTIC PAIN: AN ULTRASOUND STUDY IN PATIENTS WITH FIBROMYALGIA
Authors: M. DI Carlo, B. Bianchi, E. Cipolletta, S. Farah, E. Filippucci, F. Salaffi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fibromyalgia (FM) is a condition mainly characterized by the presence of chronic widespread musculoskeletal pain, fatigue, and sleep alterations. The pathophysiological basis of FM has not yet been clarified. It is widely recognized that FM is a condition characterized by the presence of central sensitization. The mechanisms of centralized pain have been studied mainly through functional imaging techniques. However, over the past decade, evidence of peripheral nervous system involvement has emerged alongside pathophysiological mechanisms involving the brain and spinal cord and a detailed analysis of the morphostructural abnormalities of other nerves in FM patients is still lacking. <h3>Objectives</h3> To investigate the sonographic changes [i.e., increased cross-sectional area (CSA)], of peripheral nerves in patients with FM compared to healthy controls and to identify potential clinical correlations associated with increased CSA in patients with fibromyalgia. <h3>Methods</h3> Consecutive female patients with FM included in this cross-sectional observational study underwent sonographic assessment using a standardised scanning protocol. The CSA of 7 nerves was measured bilaterally at 11 anatomic sites by an experienced sonographer. Differences in CSA of nerves were compared with those of healthy subjects by one-way analysis of variance. Patients underwent clinimetric evaluation aimed at investigating disease severity, neuropathic pain features, depression, anxiety, fatigue, and autonomic symptoms to explore the possible correlation between CSA and clinical features. <h3>Results</h3> 47 patients and 20 healthy controls were enrolled. Differences in terms of increased CSA between patients and healthy controls were identified at multiple levels, mainly at the level of the sural nerve, vagus nerve and 6<sup>th</sup> cervical nerve root (for all, p &lt; 0.001). Sonographic findings, however, did not correlate with the clinical features explored. <h3>Conclusion</h3> Patients with FM show higher CSA of nerves than healthy subjects. The increased CSA is most evident at the sural nerve, vagus nerve and 6<sup>th</sup> cervical nerve root. Ultrasound, a relatively easy-to-use technique, could identify morphological changes, in peripheral nervous structures in patients with FM. <h3>References</h3> [1]Caro XJ et al. <i>Arthritis Rheumatol</i> 2014; 66: 1945-1954. doi: 10.1002/art.38662. [2]Littlejohn G. <i>Nat Rev Rheumatol</i> 2015; 11: 639-648. doi: 10.1038/nrrheum.2015.100. [3]Di Carlo M et al. <i>Clin Exp Rheumatol</i> 2021; 39 Suppl 130: 102-107. doi: 10.55563/clinexprheumatol/r0kho4. [4]Goebel A et al. <i>J Clin Invest</i> 2021; 131: e144201. doi: 10.1172/JCI144201. [5]Kerasnoudis A et al. <i>J Neuroimaging</i> 2015; 25: 528-538. doi: 10.1111/jon.12261. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1560 QUADRICEPS FEMORIS MUSCLE PROPERTIES IN SARCOIDOSIS: FUNCTIONAL AND CLINICAL IMPLICATIONS
Authors: R. Terlemez, S. S. Kurtoglu, B. Caliskaner Ozturk, D. Palamar, E. Atahan, K. Akgun
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sarcoidosis is a chronic disease which may involve muscular system subclinically at the onset of the disease. Sarcopenia is a musculoskeletal condition that may be associated with nonspecific symptoms in patients with sarcoidosis such as general weakness, arthralgia, reduced exercise capacity, and fatigue. <h3>Objectives</h3> This study aimed to determine the association between the functionality and the quadriceps femoris muscle (QFM) thickness measured using sonography in patients with sarcoidosis. <h3>Methods</h3> Thirty-one women with sarcoidosis and 27 controls were evaluated for the following outcomes: (i) handgrip strength, (ii) QFM thickness measured using ultrasound (US), and (iii) sonographic thigh adjustment ratio (STAR). The sarcoidosis group was also evaluated using the 30-second chair stand test (30s-CST) and fatigue severity scale (FSS). <h3>Results</h3> The QFM thickness and STAR values of the sarcoidosis group were significantly lower than those of the control group (p=0.0001). However, no statistically significant difference was observed between the handgrip strengths of the groups (p=0.581). There was no statistically significant correlation between the STAR values and handgrip strength in the sarcoidosis group (p&gt;0.05); however, there was a statistically significant positive correlation between the STAR values and 30s-CST (r=0.467, p=0.008). <h3>Conclusion</h3> Probable sarcopenia is one of the musculoskeletal conditions in patients with sarcoidosis that may be associated with nonspecific symptoms, such as general weakness, exercise intolerance, and fatigue. Although the handgrip test is a frequently used test, it may not show prominent findings in the early stages of the disease. Ultrasound appears to be an innovative tool for preventing sarcopenia as it helps detect changes in muscle mass and muscle quality at an early stage. <h3>References</h3> [1]Fayad F, Lioté F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol 2006; 33:98–103. [2]Gea J, Casadevall C, Pascual S, Orozco-Levi M, Barreiro E (2012) Respiratory diseases and muscle dysfunction. Expert Rev Resp Med. 6:75–90 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1300 RHEUMATOLOGICAL MANIFESTATIONS IN A COHORT OF LONG-COVID PATIENTS: SEARCHING FOR POSSIBLE BIOMARKERS
Authors: A. Paglionico, P. Rizzuti, V. Varriano, C. Di Mario, S. Perniola, R. Calvani, A. Picca, F. Landi, M. Tosato, B. Tolusso, E. Gremese
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Approximately 10-20% of patients recovered from SARS-COV-2 infection develop persistent heterogeneous symptoms and autoantibody positivity suggesting persistence of low-grade inflammation. <h3>Objectives</h3> To assess the prevalence of rheumatological manifestations in a cohort of convalescent SARS-CoV-2 patients and to find possible biomarkers. <h3>Methods</h3> Two-hundred and seventy-nine convalescent SARS-CoV-2 patients underwent multidisciplinary assessment in our Post-Covid19 outpatient service (119 females and 160 males; mean age±SD, 55.87±0.88). For each patient, demographic, clinical and immunological data were collected. Long-COVID symptoms were assessed by a questionnaire submitted to patients; IL-1β, IL-6, TNFα and e IL-8 plasma levels were assessed by ELISA (ELLA). <h3>Results</h3> 221 (80.7%) convalescent SARS-CoV-2 patients presented at least one Long-Covid symptom, most frequently fatigue (52.6%), dyspnea (40.7%), arthralgia (28%) and myalgia (28%). The prevalence of symptoms was significantly higher in females (<i>p = 0.009</i>) and in patients 60-75 years old (<i>p = 0.02</i>) and the presence of symptoms was independent from disease severity and care setting during acute infection. Assessing cytokines plasma levels, we observed that patients presenting Long-COVID arthralgia showed higher IL-6 plasma levels <i>(p = 0.006</i>). Moreover, the most common rheumatological symptoms, asthenia and arthralgia, in Long-COVID patients were significantly correlated with female sex (<i>p = 0.002</i>), at least one autoantibody positivity (<i>p = 0.003</i>) and IL-6 plasma level higher than 2.1 pg/ml (<i>p = 0.009</i>). <h3>Conclusion</h3> Rheumatological symptoms are frequent in Long-Covid patients and this study suggests that they are underpinned by persistent dysregulated inflammatory pathways after the acute infection. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1460 CHARACTERISTICS AND EARLY OUTCOMES OF PALINDROMIC RHEUMATISM: AN INCEPTION COHORT FROM INDIA
Authors: P. Mehta, T. Skaria, M. Pai, G. B, A. Baby, S. Shan, A. Vijayan, S. Ahmed, P. Shenoy
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The exact pathogenesis and risk factors of Palindromic Rheumatism (PR) remain uncertain, however, a subgroup of patients with PR share a close relationship with rheumatoid arthritis (RA) in terms of etiopathogenesis, clinical features, serology, and outcomes. <h3>Objectives</h3> We aim to describe the characteristics of patients in an inception cohort of PR along with determinants of progression to RA. <h3>Methods</h3> Patients with symptoms suggestive of PR were screened by a rheumatologist and after relevant exclusions, were classified into PR and included in an inception cohort at the Centre for Arthritis and Rheumatism Excellence, India. Their demographics, clinical characteristics, serology, inflammatory markers, and progression to RA or any other autoimmune rheumatic disease(AIRD) were recorded. Statistical analysis was done using GraphPad Prism v9.4.1 and results are expressed as mean ± standard deviation. <h3>Results</h3> Of 706 patients screened, 685 were classified into PR (age 45.5±11.9 and male-to-female ratio of 1:2.8) with a follow-up duration of 27±20.4 months. Of those with a follow-up of greater than one year, 102 of 505 (20.2%) progressed to RA at 30± 20 months and 13 to other AIRDs. Progression to RA was positively associated with a greater number of attacks per month; severe PR or &gt;20 attacks per month; shoulder or wrist joint involvement, absence of erythema, positive rheumatoid factor, anti-CCP antibody, and ANA on univariate analysis. Additionally, they required treatment with a higher number of cDMARDs and even anti-TNFs (Table 1). On multivariate analysis, symptom duration of &lt;5 years, wrist involvement, and anti-CCP positivity were associated with progression to RA. The RF and anti- CCP titers showed no association with progression to RA. <h3>Conclusion</h3> Early outcomes of the inception cohort of PR revealed progression to RA in 20% of the cohort and was associated with symptom duration of &lt;5 years, wrist involvement, and anti-CCP positivity. The PR group was treated predominantly with colchicine and cDMARDs with a remission rate of 60%. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1579 ULTRASOUND JOINT ASSESSMENTS INCREASE DETECTION OF POLYARTICULAR JOINT INVOLVEMENT IN CHECKPOINT INHIBITORS-INDUCED ARTHRITIS
Authors: L. Meric de Bellefon, S. Aspeslagh, A. Franck, B. Jean-François, P. Durez
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> CheckPoint Inhibitors (CPI) Induced arthritis (IA) is an immune related adverse event (irAEs) occurring in 0.5 to 2% of CPI-treated patients between 3 weeks up to 24 months after initiation of therapy. IA is usually described as a seronegative oligoarticular inflammatory joint disease but IA has been for long underdiagnosed and inappropriately evaluated. <h3>Objectives</h3> To evaluate the added value of a systematic joint ultrasound assessment in these patients by the rheumatologist. <h3>Methods</h3> Patients referred by their oncologist to the Rheumatology Department for suspected arthritis had a clinical swollen joint count and a joint ultrasound assessment (GE Logiq E9 Ultrasound Machine with ML6-15-D Matrix Linear Probe). Target joints were elbows, wrists, MCP 2-5, knees, ankles and MTP1-5. The swollen joint count performed by the oncologist was compared to the one made by the rheumatologist and the US assessment. A joint was considered as positive by US assessment in case of grey-scale ≥ 1 in a scale of 3. <h3>Results</h3> 9 patients (6 males and 3 females) were assessed. Mean age was 66.1 years (SD 11 years). 4 were treated for metastatic melanoma, 1 for renal cell carcinoma (RCC), 3 for lung cancer, 1 for uterine cancer and 1 for bladder carcinoma. They received a monotherapy with pembrozilumab (4/9), nivolumab (2/9), atezolimumab (1/9), darvalumab (1/9). None had received corticosteroids. 5 out of the 9 patients were referred for an oligoarticular (swollen joint count &lt;5) presentation by the oncologist, 2 out of 9 for a polyarticular (swollen joint count ≥5) presentation and 2 for a PMR-like presentation. Whereas the rheumatological and the US assessments confirmed the polyarticular diagnoses made by the oncologists, the 5 oligoarticular-labelled patients had polyarticular involvement after the rheumatologist and US assessements. In the 2 patients referred for a PMR-like disease, US assessments showed one polyarticular and one oligoarticular presentation. None of the 9 patients had positive rheumatoid factors (RF) or anticitrullinated peptides antibodies (ACPAs). <h3>Conclusion</h3> In this small group of patients with CPI-IA, In this small group of patients with CPI-IA, we found that US joint assessment led to a better classification of polyarticular joint involvement, present in the majority of the cases. Our results emphasise the importance of a multidisciplinary approach of these patients and support the use of US joint assessments in CPI-IA patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1420 PAEDIATRIC PRESENTATION OF ANTIPHOSPHOLIPID SYNDROME: A REVIEW OF RECENT LITERATURE WITH ESTIMATION OF LOCAL PREVALENCE
Authors: M. Radin, I. Cecchi, M. Arbrile, D. Montin, L. Farinasso, M. Cioffi, S. G. Foddai, A. Barinotti, E. Menegatti, S. Baldovino, S. Sciascia, D. Roccatello
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> No evidence exists on any study investigating the prevalence of paediatric Antiphospholipid Syndrome (APS) in the general population (1) and most of the available recommendations on how to manage these patients come from observational studies and physicians' experience. <h3>Objectives</h3> We aimed to investigate the epidemiology, the clinical and laboratory characteristics of the paediatric involvement of Antiphospholipid syndrome (APS), by performing a systematic review of the current evidence and reviewing local experience in the Northwest Italy. <h3>Methods</h3> We performed a detailed literature search to identify articles describing clinical and laboratory characteristics of paediatric APS patients. In concomitance, we conducted a registry-study collecting data from the Piedmont and Aosta Valley Rare Disease Registry including paediatric patients diagnosed with APS in the last ten years. <h3>Results</h3> The systematic review included nine articles with a total of 386 paediatric patients [65% females, 50% with Systemic Lupus Erythematosus (SLE) as concomitant diagnosis]. Rate of venous and arterial thrombosis were 57% and 35% respectively. "Extra-criteria manifestations" of APS included mostly hematological and neurological involvement (91 thrombocytopenia, 32 haemolyticanaemia, 19 chorea, 8 multiple sclerosis-like lesions, 9 migraines and one transverse myelitis). Almost one quarter of patients (19%) reported recurrent events and 13% manifested as CAPS. Further details of the included studies are detailed in Table 1. A total of 17 paediatric patients (mean age 15.1 ±2.8, 76% female) developed APS in the Northwest of Italy. In 29% of cases SLE was a concomitant diagnosis. Deep vein thrombosis was the most frequent manifestation (28%) followed by Catastrophic APS (CAPS) (6%). Taking into account that the paediatric population of the Piedmont and Aosta Valley Region is around 680,000 persons, the calculated estimated prevalence of paediatric APS in Piedmont and Aosta Valley Region is 2.5 cases per 100,000 people. When analyzing the data of the register in an eleven year period (from January 2011 to December 2021), the estimated mean annual incidence was 0.2 cases per 100,000 inhabitants. <h3>Conclusion</h3> Clinical manifestations of paediatric APS seem to be more severe and with a high prevalence of non-criteria manifestations. International efforts are needed to better characterize this condition and to develop new specific diagnostic criteria to avoid missed/delayed diagnosis in children with APS. <h3>References</h3> [1] Petri M. Epidemiology of Antiphospholipid Syndrome. In: Hughes Syndrome. London: Springer-Verlag; 2006:22–28. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1487 EFFECTIVENESS OF RITUXIMAB IN IGG4-RELATED DISEASE. MULTICENTRE STUDY AND LITERATURE REVIEW
Authors: L. Sanchez-Bilbao, J. Loricera, A. Herrero-Morant, C. Álvarez-Reguera, R. Melero, E. Galíndez-Agirregoikoa, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease often associated with elevated serum IgG4 levels. High dose corticosteroids are the cornerstone of treatment, but relapses and side-effects are frequent, requiring synthetic and/or biologic immunosuppressants. Rituximab (RTX) seems to be useful. <h3>Objectives</h3> To assess the effectiveness of RTX in IgG4-RD refractory to conventional treatment. <h3>Methods</h3> Multicentre clinical practice study of IgG4-RD patients treated with biologic therapy. For the literature review, a search of PubMed, Embase and the Cochrane library was conducted from inception to 31 Dec 2022. <h3>Results</h3> We include 9 patients (5 women/4 men) (mean age±SD; 55.8±12.6 years) with refractory IgG4-RD, treated with RTX <b>(Table 1).</b> The affected organs were: aorta (n=5), lymph nodes (n=3), lung/pleura (n=2), retroperitoneum (n=2), lacrimal glands (n=1), salivary glands (n=1), orbit (n=1), subglotis (n=1), kidney (n=1), pericardium (n=1), biliary duct (n=1) and mesenterium (n=1). All patients had received oral corticosteroids, (mean±SD dose of 33.9±14.1 mg/day). Two patients also received corticosteroid boluses. Six of the patients received conventional cDMARDs. The cDMARDs received were: methotrexate (MTX) (n=4), azathioprine (n=1), and hydroxychloroquine (n=1). RTX schedule was of 1g x 2 (n=8), and 375 mg/m2 (n=1). After a median [IQR] follow-up of 27 [25-48] months, complete and partial clinical improvement was observed in 6 and 2 patients respectively. One patient died due to an acute myocardial infarction, while another patient developed a breast cancer. We found 3 series, in the literature review, showing RTX effectiveness <b>(Figure 1).</b> The most frequently used RTX regimen was 1g x 2. <h3>Conclusion</h3> RTX seems to be an effective and safe therapy in corticosteroid-refractory IgG4-RD. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Lara Sanchez-Bilbao: None declared, Javier Loricera Speakers bureau: Roche, Novartis, UCB Pharma, MSD, Celgene, and Grünenthal, Alba Herrero-Morant: None declared, Carmen Álvarez-Reguera: None declared, Rafael Melero: None declared, E. Galíndez-Agirregoikoa Speakers bureau: Celgene, AbbVie, Pfizer, Roche, Lilly, MSD, Janssen, and Bristol, Ricardo Blanco Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Lilly, Janssen, and MSD, Grant/research support from: AbbVie, MSD, and Roche.
Venoarterial Extracorporeal Membrane Oxygenation After Autologous Stem Cell Transplantation With Pancytopenia
Authors: James F. Howick V, Joshua A. Rezkalla, Thomas Tilbury, Sunil V. Mankad, Courtney E. Bennett, Joerg Herrmann, Gregory Barsness, Stephen M. Ansell, Matthew D. Read
Journal: Journal of the American College of Cardiology (2023)
AB1370 DEMOGRAPHICAL, SOCIOPROFESSIONAL FACTORS AND HABITS ASSOCIATED WITH CHRONIC WIDESPREAD PAIN IN A LARGE GENERAL POPULATION COHORT
Authors: F. Bailly, A. Petit, S. Kab, V. Foltz, M. Badard, B. Fautrel
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Clinical and demographic characteristics associated with chronic widespread pain (CWP) are well known, contrary to the social and professional characteristics in general population. <h3>Objectives</h3> To evaluate the set of characteristics associated with CWP. <h3>Methods</h3> The Constances cohort consisting of randomly selected volunteers aged 18 to 69 years, between 2013 and 2020 in France (ref). An ancillary study from this cohort aims to identify musculoskeletal pain using the Nordic Questionnaire. Chronic pain was defined as pain in at least 4 of the 6 areas, during at least 30 days during the previous year. Individuals diagnosed with a cancer were excluded. Demographic, clinical, social, and occupational data at inclusion were collected. Missing data were imputed. Multivariate analysis was performed. <h3>Results</h3> 193,436 people were included, of whom 7% (13,447 people) suffered from CWP. Female gender, age, higher BMI, depression, medium or high physical activity at work, current or past smoking, less sleep duration, and low socioprofessional category were associated with CWP. Diploma was a protective factor, as well as leisure physical activity, while job search, household income, alcohol or cannabis were not or poorly associated with CWP. <h3>Conclusion</h3> CWP remains frequent in the French general population and is significantly associated with specific socioeconomic factors. <h3>Reference</h3> [1]Zins M et al. 2015 <i>Eur J Epidemiol</i> <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1545 A COMPARATIVE ANALYSIS BETWEEN THERMAL AND ULTRASOUND IMAGING AT THE ELBOW IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Y. K. Tan, R. Sultana, J. Thumboo
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Thermal imaging (TI) is a relatively low cost, non-invasive imaging technique that offers a quick and objective measurement of joint surface temperature. However, TI data at the elbow in patients with rheumatoid arthritis (RA) is presently lacking. <h3>Objectives</h3> The aim of this study is to compare TI outcomes with ultrasound (US) joint inflammation findings at the elbow among patients with RA. <h3>Methods</h3> TI and US imaging were performed at the same study visit. TI was carried out in a draft free room following a standardized protocol. The maximum (Tmax), average (Tavg) and minimum (Tmin) temperatures at the elbow (anterior, posterior, lateral and medial aspects) were summed up to obtain the respective MAX, AVG and MIN temperatures for the right and left elbows. Ultrasound power Doppler (PD) and greyscale (GS) joint inflammation were graded semi-quantitatively (0-3) at the anterior (humeroradial) and posterior fossa recesses of the elbow joint using previously validated scoring methods; and these were summed to obtain the respective PD and GS scores at the right and left elbows per patient. Pearson's correlation coefficient was used to correlate the findings from TI and US imaging, while simple linear regression was used to describe the relationship between parameters. <h3>Results</h3> In this cross-sectional study, 60 elbows were evaluated by TI and US imaging among 30 adult RA patients with the following patient baseline characteristics: 76.7% female; 76.7% Chinese; mean (SD) disease duration 7.3 (6.8) months; mean (SD) DAS28 3.83 (1.19). Table 1 shows the results of the comparative analysis between the TI parameters (MAX, AVG and MIN) and the US PD and GS scores. For Pearson's correlation, the TI parameters (MAX, AVG and MIN) were all significantly correlated (P&lt;0.05) with the US PD scores (Table 1) at both the right and left elbows. For US GS scores (Table 1), significant correlation (P&lt;0.05) were observed with all the TI parameters (MAX, AVG and MIN) only at the right elbow but not at the left elbow (with P-values all &gt;0.05). The simple linear regression estimates between TI and US imaging parameters at the right and left elbows are summarized in Table 1. <h3>Conclusion</h3> To the best of our knowledge, our study is the first to report on the correlation analysis between TI parameters and US joint inflammation outcomes at the elbow from an RA cohort. Between US PD and GS joint inflammation, TI is more consistently associated with the former at the elbow in RA. TI of the elbow in RA appears promising and will require further validation in independent RA cohorts. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.